Vitamin B9 (Folic Acid) - Deficiency Risk and Symptoms

Nutrient Name

Vitamin B9 - otherwise known as Folate (naturally occurring in foods) or Folic Acid (a synthetic folate compound used in vitamin supplements because of its increased stability). The name comes from ‘folium’, which is the Latin word for leaves, because folates were first isolated from spinach.

Potential for deficiency

Very Common

Folate deficiency is one of the commonest vitamin deficiencies. It can result from inadequate intake, defective absorption, abnormal metabolism or increased requirements such as when pregnant or breastfeeding.

Pregnant and breast-feeding women are at a higher risk of vitamin B9 deficiency due to rapid tissue growth during pregnancy and to losses through the milk during breast-feeding, an increased folate/folic acid intake is therefore required.

In most European countries, the average vitamin B9 (folate) intake is below national recommendations.

What does Vitamin B9 do?

An adequate intake of Vitamin B9 is important as it helps the body as a to utilise amino acids which are the building blocks of proteins. It helps the body form blood cells in bone marrow and ensures rapid cell growth in infancy, adolescence, and pregnancy. Vitamin B9 plays a crucial role in producing nucleic acids (e.g., DNA), the body's genetic material.

Together with Vitamin B6 and Vitamin B12 it also helps control blood levels of the amino acid homocysteine which is associated with certain chronic conditions such as heart disease.

The European Food Safety Authority (EFSA) confirms that clear health benefits have been established for the dietary intake of folic acid (vitamin B9) in contributing to:

• normal blood formation
• normal homocysteine levels (high levels of homocysteine are related to the early development of heart and blood vessel disease)
• a normal metabolism of the immune system
• normal cell division
• normal maternal tissue growth during pregnancy
• normal amino acid synthesis
• normal psychological functions
• the reduction of tiredness and fatigue

Food Sources

Folate is found in a wide variety of foods but the richest sources are liver, dark green leafy vegetables (broccoli, brussels sprouts and spinach), beans and yeast. Other sources include eggs (specifically the yolk), milk and dairy products, beets, orange juice and whole wheat bread.

Folic acid (Vitamin B9) is a water-soluble vitamin and as such, it is unlikely to reach toxic levels. There is little danger of toxicity when it is taken orally. No adverse effects have been associated with the consumption of excess dietary folic acid.

Folic acid cannot be stored in the body, so you need it in your diet every day. Adults need 200 mcg of folic acid a day. However, if you are pregnant, thinking of trying to have a baby or likely to become pregnant, the NHS recommend that you take a 400 mcg folic acid supplement daily from the time you stop using contraception until the 12th week of pregnancy. This is to help prevent birth defects of the central nervous system, such as spina bifida, in your baby.

Symptoms of deficiency

• tiredness
• irritability and loss of appetite
• severe folate deficiency leads to a condition in which the bone marrow produces oversized immature red blood cells - this is called megaloblastic anemia
• in pregnant women folic acid deficiency can result in severe or even fatal birth defects such as neural tube defects